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Office Policy
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REPLENISH
Center for Natural/Bioidentical Hormone Restoration
Office Policy
1. Our office does Not accept insurance plan payments. We are a fee for service office. Patients are responsible for payment in full for services rendered to them. Methods of payment include cash, money order, check, and major credit cards. Payment is due at the time of the service. Payment plans can be arranged.
2. Upon request a detailed, itemized receipt is provided. This can be submitted to your insurance company if desired. We are not responsible for denials, non-payments by your insurance company, or filing appeals to insurance companies.
3.Some Insurance companies may not cover prescriptions called in to the compounding pharmacy therefore the compounding pharmacy will call you directly for a method of payment prior to shipping.
4. All lab results are reviewed and discussed with you during consultation times. Results can only be given over the phone during a phone consultation with the doctor. The charge for the phone consult will depend on the amount of time required for the consult.
5. Medical questions should be addressed during consultation times. Our staff may handle brief questions but in-depth questions will require an appointment with the doctor.
6. The doctors are available for phone consultations for the convenience of our patients who live out of town or have schedules which do not permit them to come in for office visits.
7. Prescription refills are called in within 48 hours of the request. Patients who have not been seen recently may need to be reevaluated before a prescription is called in.
8. Patients are responsible for payments for labs performed. No refund can be given once a lab test has been performed. If you decide not to perform a lab test you must return the lab test kit along with your receipt to receive a refund. Refunds for lab test kits are given up to 14 days after purchase. Preparation, shipping and handling of your test kit is $25.00
9. Please call as soon as possible to let us know if you cannot keep your appointment. In order to provide better service to our patients we do not overbook to compensate for no shows, therefore we must bill for missed appointments. There is a $150.00 cancellation fee for patients who do not cancel their consultation appointment prior to 24 hours.
10. If you are late for an appointment you will be seen only for the remainder of your appointment time in order to avoid delays for other patients.
11. If you go over your scheduled appointment time you will be charged for the additional time spent with the doctor. Please be sure to review our Office Fee Schedule.
12. We do not provide disability forms for patients who desire disability coverage. Your primary care physicians must complete these forms.
13. Our office specializes in bio-identical hormone restoration. We do not assume the responsibility for treatment of major medical illnesses that you are currently being cared for by your primary physician or other care provider. Please continue treatment with your primary care or OB/GYN for routine medical problems.
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Fee Schedule
New Patient:
$350.00 + Salivary Testing for Traditional BHRT.
$250.00 + Blood Testing + Insertion + Pellets for Pellet BHRT.
Follow up Consultations:
$150.00 + Salivary Testing if necessary (Traditional BHRT)
$150.00 + Insertion + Pellets + Blood Testing, if indicated.
Salivary Testing:
The cost will be $170 - $200 based on the number of hormones being tested. This cost may be covered by your insurance The lab will work with you to obtain assistance from your insurance carrier. You will deal directly with the lab for this cost.
Saliva Test Kit cost $25.00 for preparation, handling and shipping to you.
Blood Testing:
If you have insurance, the cost to the lab will be your agreed upon co-pay.
If you do not have insurance, we have negotiated with the lab a reduced price of approximately $100.
By placing your initials in the box below you acknowledge that you have read this document and agree to abide by our office policies.
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